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      Post-traumatic stress disorder.

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          Abstract

          Post-traumatic stress disorder (PTSD) occurs in 5-10% of the population and is twice as common in women as in men. Although trauma exposure is the precipitating event for PTSD to develop, biological and psychosocial risk factors are increasingly viewed as predictors of symptom onset, severity and chronicity. PTSD affects multiple biological systems, such as brain circuitry and neurochemistry, and cellular, immune, endocrine and metabolic function. Treatment approaches involve a combination of medications and psychotherapy, with psychotherapy overall showing greatest efficacy. Studies of PTSD pathophysiology initially focused on the psychophysiology and neurobiology of stress responses, and the acquisition and the extinction of fear memories. However, increasing emphasis is being placed on identifying factors that explain individual differences in responses to trauma and promotion of resilience, such as genetic and social factors, brain developmental processes, cumulative biological and psychological effects of early childhood and other stressful lifetime events. The field of PTSD is currently challenged by fluctuations in diagnostic criteria, which have implications for epidemiological, biological, genetic and treatment studies. However, the advent of new biological methodologies offers the possibility of large-scale approaches to heterogeneous and genetically complex brain disorders, and provides optimism that individualized approaches to diagnosis and treatment will be discovered.

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          Author and article information

          Journal
          Nat Rev Dis Primers
          Nature reviews. Disease primers
          Springer Nature
          2056-676X
          2056-676X
          October 08 2015
          : 1
          Affiliations
          [1 ] James J. Peters Veterans Affairs Medical Center, 130 West Kingsbridge Road, New York, New York 10468, USA.
          [2 ] Icahn School of Medicine at Mount Sinai, New York, New York, USA.
          [3 ] Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
          [4 ] Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, South Australia, Australia.
          [5 ] Military Mental Health Research Center, Ministry of Defense, Utrecht, The Netherlands.
          [6 ] Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
          [7 ] Arq Psychotrauma Expert Group, Diemen, The Netherlands.
          [8 ] Department of Psychiatry, Western University of Canada, London, Ontario, Canada.
          [9 ] Department of Psychiatry, School of Medicine, University of California at San Diego, La Jolla, California, USA.
          [10 ] VA Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, La Jolla, California, USA.
          [11 ] Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA.
          [12 ] Department of Epidemiology, Harvard T.H. Chan School of Public Health and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
          [13 ] The Stanley Center, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
          [14 ] Department of Psychiatry, University of California San Francisco, San Francisco, California, USA.
          [15 ] Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
          [16 ] Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA.
          Article
          nrdp201557
          10.1038/nrdp.2015.57
          27189040
          a1d2a384-f00f-4e53-81b5-36a68dc1e7c8
          History

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